Pokes and Prods
Instruments of Torture
Shocking!
Blood Goes Round
Aw, S**t!
100
Which of the following would NOT be considered an invasive diagnostic test? a) Venous blood draw b) Chest CT c) Skin biopsy d) Bronchoscopy
b) Chest CT
100
Which of the following is primarily a nursing responsibility during the intraoperative phase? a) Obtaining informed consent from the patient b) Assessing for atelectasis c) Ensuring patient is safely positioned d) Talking with patient's family members about what to expect
d) Ensuring patient is safely positioned
100
A patient develops low BP and tachycardia and is very agitated. The nurse remembers that a central line was placed 3 hours ago. The patient's lung sounds are decreased on one side, and tracheal deviation is present. The nurse realizes that this patient most likely experiencing which type of shock? a) Hypovolemic shock b) Obstructive shock c) Anaphylactic shock d) Neurogenic shock
b) Obstructive shock
100
A 24 year-old female client who has a history of depression is admitted with confusion and lethargy. She was found at home with an empty bottle of aspirin next to her in the bed, along with a suicide note. Vital signs reveal a blood pressure of 104/72 mm Hg, pulse rate of 116 and regular, respiratory rate of 42 and deep. Which of the following arterial blood gases should the nurse expect? a) pH 7.38, PaO2 96 mmHg, PaCO2 38 mmHg, HCO3 24 mEq/L b) pH 7.48, PaO2 100 mmHg, PaCO2 28 mmHg, HCO3 23 mEq/L c) pH 6.98, PaO2 100 mmHg, PaCO2 30 mmHg, HCO3 18 mEq/L d) pH 7.58, PaO2 96 mmHg, PaCO2 38 mmHg, HCO3 19 mEq/L
c) pH 6.98, PaO2 100 mmHg, PaCO2 30 mmHg, HCO3 18 mEq/L
100
Identify which of the following food choices are appropriate for a client attempting to increase dietary fiber: (Select all that apply) Bran cereal, fresh pear, chicken, frozen spinach, yogurt, orange, white toast, baked potato.
Bran cereal, fresh pear, frozen spinach, orange, baked potato
200
A patient is 18 hours post-operative from a femoral artery angiogram procedure. Which of the following statements by the patient indicates that further teaching is needed? a) "I should be frequently drinking fluids." b) "I expect you to continue assessing the pulses in my feet." c) "My pressure dressing could have been removed hours ago." d) "It is typically okay for me to flex my leg six hours after the procedure."
c) "My pressure dressing could have been removed hours ago."
200
The morning before a scheduled hysterectomy related to uterine cancer, the client informs the nurse that she does not want to go through with the procedure. Which of the following steps should the nurse take next? a) Inform the client that the surgery is necessary and that there is nothing to worry about b) Notify the surgeon that the client is refusing surgery and needs to be sedated. c) Inform the surgeon of the client's statement so that the surgeon can talk with the client. d) Note the client's statement on the chart and reassess the client.
c) Inform the surgeon of the client's statement so that the surgeon can talk with the client.
200
During a conversation about a patient, a new nurse states "His BP is 92/50, so he can't be in shock." Which of the following indicates that the nurse does not completely understand the symptoms of shock? a) Patients can have a near-normal BP, yet still have inadequate tissue perfusion b) The cutoff for shock is a systolic pressure of 100 mm Hg c) Shock is determined by mean arterial pressure d) Shock is determined by a heart rate of over 100
a) Patients can have a near-normal BP, yet still have inadequate tissue perfusion
200
An adult male client was involved in a single-vehicle car crash. He is reporting chest pain and difficulty breathing. A chest x-ray reveals a pneumothorax. Blood gas analysis is obtained. Which of the following results should the nurse expect? a) pH 7.06, PaO2 96 mmHg, PaCO2 52 mmHg, HCO3: 24 mEq/L b) pH 7.42, PaO2 100 mmHg, PaCO2 38 mmHg, HCO3: 23 mEq/L c) pH 6.98, PaO2 100 mmHg, PaCO2 30 mmHg, HCO3: 18 mEq/L d) pH 7.58, PaO2 96 mmHg, PaCO2 38 mmHg, HCO3: 29 mEq/L
a) pH 7.06, PaO2 96 mmHg, PaCO2 52 mmHg, HCO3: 24 mEq/L
200
Which question will best assist the nurse in the assessment of a patient with acute diarrhea? a) "Have you had a colonoscopy in the last three months?" b) "Have you traveled outside the country recently?" c) "Do you have any trouble swallowing?" d) "Do you have any allergies?"
b) "Have you traveled outside the country recently?"
300
The nurse is taking a history on a patient who is to undergo a contrast CT of the abdomen. Which of the following statements made by the patient would be a contraindication to the procedure? a) "I haven't eaten in days." b) "I am allergic to shellfish." c) "My mother died of a heart attack at a very young age." d) "A car accident has left me paralyzed from the waist down."
b) "I am allergic to shellfish."
300
A 70 year-old elderly patient is admitted to the preoperative unit for a liver resection that is scheduled for six hours of surgery. What is one of the basic principles that should guide the preoperative nurse's assessment? a) Elderly patients do not experience as much preoperative anxiety as younger patients b) The elderly patient has less physiological reserve than the younger patient c) Elderly patients experience less pain d) Preoperative pain assessment and teaching should occur following the procedure as the elderly patient may not retain the information
b) The elderly patient has less physiological reserve than the younger patient
300
When caring for a critically ill patient who is being mechanically ventilated, the nurse will astutely monitor for which clinical manifestation of multiple organ dysfunction syndrome (MODS)? a) Increased serum albumin b) Decreased respiratory compliance c) Increased gastrointestinal (GI) motility d) Decreased blood urea nitrogen (BUN)/creatinine ratio
b) Decreased respiratory compliance
300
Interpret the following ABG result: pH 7.49, PaCO2 30 mmHg, HCO3 23 mEq/L, SpO2 96%
Respiratory alkalosis
300
The nurse recognizes that most nutrients and electrolytes are absorbed by which of the following? a) Esophagus b) Stomach c) Colon d) Small intestine
d) Small intestine
400
Risks involved with an upper endoscopy include all of the following EXCEPT: a) Bleeding b) Infection c) Tearing of the GI tract d) Bowel obstruction
d) Bowel obstruction
400
A nurse is caring for a postoperative patient in POD 2. The patient had a large upper abdominal incision. While assessing the patient at the beginning of her shift, the nurse noted decreased breath sounds, crackles, and a mild cough. What is the patient most likely experiencing? a) Atelectasis b) Pneumonia c) Acute bronchitis d) Hypoxemia
a) Atelectasis
400
A client has the following electrolyte results: Na+ 133 mEq/L, K+: 3.4 mEq/L. Which of the following treatments likely resulted in these results? a) Three tap water enemas b) Normal saline 50 mL/hr c) D5W with 20K+ 80 mL/hr d) Administration of glucocorticoids
a) Three tap water enemas
400
Interpret the following ABG result: pH 7.40, PaCO2 40 mmHg, HCO3 24 mEq/L, SpO2 98%
Normal
400
Which assessment finding does the nurse expect as a normal consequence of aging? a) Increased salivation and drooling b) Hyperactive bowel sounds and loose stools c) Increased gastric production and heartburn d) Decreased sensation to defecate and constipation
d) Decreased sensation to defecate and constipation
500
A client is concerned with the claustrophobia she may feel inside of an MRI machine. The nurse knows an MRI imaging procedure typically lasts: a) 15-30 mins. b) 30-60 mins. c) 60-90 mins. d) 90-120 mins.
c) 60-90 mins.
500
Which National Patient Safety Goal (NPSG) requirement is enacted immediately before surgery with a surgical time-out? a) Prevention of infection b) Improved staff communication c) Identify patients at risk for suicide. d) Patient, surgical procedure, and site are checked.
d) Patient, surgical procedure, and site are checked.
500
Hyperkalemia can be triggered by which of the following conditions? a) Diabetic ketoacidosis b) CHF c) Diabetes insipidus d) Thyroidectomy
a) Diabetic ketoacidosis
500
A patient comes into the emergency department with lethargy and a headache. You obtain the patient's vital signs and discover the patient has a blood pressure of 88/54. An ECG reading shows sinus rhythm with intermittent PVCs. What ABG value is likely out of normal range?
PaCO2 (The patient is hypercapnic)
500
Which assessment data indicate the client with diarrhea is experiencing a complication? a) Moist buccal mucosa b) A 3.6 mEq/L potassium level c) Tented tissue turgor d) Hyperactive bowel sounds
c) Tented tissue turgor
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